Sustainable Careers for Advanced Critical Care Practitioners (ACCPs)

Published 10/01/2023


  1. We encourage open dialogue whereby ACCPs can agree their working patterns in consultation with the unit clinical lead, consultant ACCP supervisor and where applicable the lead ACCP.
  2. With advancing seniority, and in consultation with the clinical lead or consultant ACCP supervisor, ACCPs may undertake additional non-clinical work to support the unit and the specialty of intensive care medicine. We advocate formal recognition of these roles and rostering them into a job plan that equates to 80/20 split of direct clinical care and supporting professional activities (SPA) respectively.
  3. As experienced ACCPs take on other roles, it is important to maintain a predominantly clinical commitment for the retention of skills, knowledge, and capability. The FICM suggest that an ACCP’s clinical commitment should be no lower than 70% of whole-time activity.
  4. We encourage open dialogue between the unit clinical lead, consultant ACCP supervisor or lead ACCP with ACCPs aged over 55 on what constitutes an appropriate working pattern with advancing age. This must be tailored to the physical and psychological needs of the ACCP whilst recognising that critical care is a 24/7 specialty.
  5. We recommend 10 days of professional leave per year in addition to SPA time for a full time ACCP with an agreed study budget (prorated for those part time).
  6. ACCPs whether in training or qualified, must have a dedicated educational supervisor who is a consultant in critical care medicine. A consultant ACCP supervisor must have this educational commitment recognised in their job plan. We recommend 0.25PA per trainee ACCP and 0.125PA per trained ACCP, unless specific demands suggest that this should be amended. 
  7. Staff new to the role of ACCP should be allocated a mentor. This should ideally be another more experienced ACCP in the same critical care unit; where this is not possible, a more experienced ACCP in a neighbouring unit within the same critical care Operational Delivery Network would be appropriate.
  8. ACCPs should be independently represented at critical care unit meetings and in the Advanced Practice workstreams within the Trust/Health Board. Where an ACCP is unable to attend, the consultant ACCP supervisor may represent their views.
  9. The physical working conditions and facilities for rest applicable to ACCPs should align with other resident decision makers.
  10. Organisations who employ ACCPs, be they in training or following qualification, should align their banding structure with that described in this document. This follows the recommendations for advanced practice roles from The Centre for Advancing Practice, Health Education England. Broadly: trainee ACCP (band 7), ACCP (band 8a), senior ACCP (band 8a or 8b – banding to be decided locally), lead ACCP (band 8b), ACCP consultant (band 8c).
  11. The knowledge, skills, attitudes, and experience that define each tier of ACCP seniority are described in this document.